Newborns are delicate beings, and their health requires special attention, particularly in the early days of life. One common condition that affects many newborns is jaundice, a condition that can cause a yellowish tint to the skin and the whites of the eyes. In most cases, jaundice is harmless and resolves on its own. However, when it persists or becomes severe, treatment is necessary. One of the most common treatments for newborn jaundice is phototherapy. This article will explore whether phototherapy is good for newborns, discussing the benefits, potential risks, and what parents should know before considering this treatment.
Understanding Newborn Jaundice
Jaundice in newborns occurs due to an excess of bilirubin in the blood. Bilirubin is a yellow pigment produced during the normal breakdown of red blood cells. In newborns, especially those born prematurely, the liver may not yet be fully developed to process and eliminate bilirubin efficiently. This leads to its accumulation in the blood, causing jaundice.
Why is Phototherapy Used?
Phototherapy is the most widely used treatment for newborn jaundice. The therapy involves exposing the baby’s skin to a type of light that helps break down bilirubin into a form that can be more easily excreted by the body. The light used in phototherapy is usually blue or white, and the treatment is often done in a hospital setting, though home phototherapy units are also available in some cases.
How Does Phototherapy Work?
Phototherapy works by altering the structure of bilirubin molecules in the baby’s skin. This process, known as photoisomerization, changes bilirubin into a form that the baby’s body can more easily process and eliminate. The light penetrates the skin and is absorbed by the bilirubin, leading to its breakdown. The now-soluble bilirubin can be excreted in the baby’s urine and stool.
Benefits of Phototherapy for Newborns
Effective in Reducing Bilirubin Levels
Phototherapy is highly effective in reducing bilirubin levels in newborns. It is the first-line treatment for jaundice and is usually sufficient to bring bilirubin levels down to a safe range. In most cases, phototherapy can prevent the need for more invasive treatments, such as exchange transfusion, where the baby’s blood is replaced with donor blood to quickly lower bilirubin levels.
Non-Invasive and Painless
One of the major benefits of phototherapy is that it is a non-invasive and painless treatment. Unlike other medical procedures, phototherapy does not involve needles, incisions, or medications. The baby simply lies under a special light, usually wearing only a diaper and eye protection. This makes the treatment less stressful for both the baby and the parents.
Can Be Administered in Various Settings
Phototherapy can be administered in different settings, including hospitals, clinics, and even at home with the appropriate equipment. This flexibility allows parents to choose the most convenient and comfortable setting for their baby, depending on the severity of the jaundice and the availability of resources.
Potential Risks and Side Effects
Dehydration
One of the potential risks of phototherapy is dehydration. The light used in the treatment can cause the baby to lose more fluids through their skin. To counteract this, it is essential to ensure that the baby is well-hydrated, either through breastfeeding or formula feeding. In some cases, intravenous fluids may be necessary if the baby becomes dehydrated.
Eye Damage
To protect the baby’s eyes from the bright light, special eye shields are used during phototherapy. However, if these shields are not properly fitted or if the baby moves too much, there is a small risk of eye damage. It is crucial for healthcare providers to monitor the baby closely and adjust the eye protection as needed.
Temperature Instability
Newborns under phototherapy may experience fluctuations in body temperature. The light can cause the baby to become too warm or, conversely, too cold if they are underdressed. Regular temperature checks are necessary to ensure the baby remains within a safe temperature range during treatment.
Interruption of Bonding and Breastfeeding
Phototherapy can sometimes interrupt the natural bonding process between mother and baby, as the baby needs to spend time under the lights. This can also affect breastfeeding, especially if the baby is kept under the lights for extended periods. However, many hospitals now encourage “rooming-in” or allow breaks from phototherapy to promote bonding and breastfeeding.
When is Phototherapy Recommended?
Bilirubin Levels and Risk Factors
Phototherapy is recommended when a newborn’s bilirubin levels reach a point where there is a risk of complications, such as kernicterus, a form of brain damage caused by very high bilirubin levels. The decision to start phototherapy is based on the baby’s bilirubin levels, age in hours, gestational age, and the presence of risk factors such as prematurity or blood group incompatibility.
Guidelines for Treatment
The American Academy of Pediatrics (AAP) provides guidelines on when to initiate phototherapy based on bilirubin levels and other factors. These guidelines help healthcare providers make informed decisions about whether a baby needs phototherapy and how long the treatment should continue. It is important to follow these guidelines closely to avoid unnecessary treatment or delay in necessary intervention.
SEE ALSO: When is Phototherapy Indicated for Newborns?
How is Phototherapy Administered?
Types of Phototherapy
There are different types of phototherapy used to treat newborn jaundice:
Conventional Phototherapy: This is the most common form of phototherapy, where the baby is placed under a fluorescent lamp or LED light.
Fiberoptic Phototherapy: Also known as “biliblanket,” this method involves wrapping a light-emitting pad or blanket around the baby. This allows for more flexibility, and the baby can be held or fed while receiving treatment.
Double-Sided Phototherapy: This method uses lights above and below the baby to increase the effectiveness of the treatment by exposing more skin surface to the light.
Duration of Treatment
The duration of phototherapy varies depending on the severity of the jaundice and the baby’s response to treatment. Some babies may need only a few hours of phototherapy, while others may require several days. The baby’s bilirubin levels are monitored regularly, and phototherapy is continued until the levels drop to a safe range.
Parental Concerns and Considerations
Safety of Phototherapy
One of the primary concerns for parents is the safety of phototherapy. While the treatment is generally safe, it is not without risks, as discussed earlier. Parents should feel comfortable discussing these risks with their healthcare provider and asking questions about how the treatment will be administered and monitored.
Impact on Baby’s Development
Another concern is whether phototherapy has any long-term effects on the baby’s development. Research has shown that phototherapy is safe and does not have adverse long-term effects on a baby’s growth and development. However, parents should be aware of the potential short-term side effects, such as dehydration and temperature instability, and work with their healthcare provider to mitigate these risks.
Home Phototherapy: Is It an Option?
In some cases, home phototherapy may be an option for babies with mild to moderate jaundice. This allows the baby to receive treatment in the comfort of their own home, reducing the stress of hospital visits. However, home phototherapy should only be considered under the guidance of a healthcare provider who can provide the necessary equipment and monitor the baby’s progress.
Alternatives to Phototherapy
Exchange Transfusion
For babies with extremely high bilirubin levels or when phototherapy is not effective, an exchange transfusion may be necessary. This procedure involves replacing the baby’s blood with donor blood to rapidly lower bilirubin levels. Exchange transfusion is a more invasive procedure and carries higher risks than phototherapy, so it is usually reserved for severe cases.
Intravenous Immunoglobulin (IVIG)
In cases where jaundice is caused by blood group incompatibility, such as Rh or ABO incompatibility, intravenous immunoglobulin (IVIG) may be used to reduce bilirubin levels. IVIG is administered through an IV and works by preventing the breakdown of red blood cells that leads to an increase in bilirubin.
Enhanced Nutrition and Hydration
In mild cases of jaundice, increasing the baby’s fluid intake through breastfeeding or formula feeding can help lower bilirubin levels naturally. Ensuring the baby is well-hydrated helps promote the excretion of bilirubin through urine and stool.
Conclusion
Phototherapy is a widely accepted and effective treatment for newborn jaundice. It offers numerous benefits, including the ability to reduce bilirubin levels quickly, non-invasively, and safely. While there are potential risks and side effects, these are generally manageable with proper care and monitoring. Parents should feel empowered to ask questions and seek information from their healthcare providers to make informed decisions about their baby’s care. Ultimately, phototherapy is a valuable tool in ensuring the health and well-being of newborns with jaundice, helping them start life on a healthy note.
